JHM Research Series

The JHM Research Series highlights some of the most recent and impactful research coming out of the Journal of Hospital Medicine, SHM’s peer-reviewed research journal. Read what contributors and primary investigators have to say about the latest hospital medicine research. Visit www.journalofhospitalmedicine.com for more.

Do hospital-based docs get sued more? Part II

  I left off last week’s post with a tease.  If you recall, I made note of the frequent mentions med mal gets in the lay and professional press, as well as the outsized influence the threat of getting sued has on physician psyches. Physician surveys, albeit with their biases, can tell us how we feel about medical torts.  However, as a field, from those same surveys, we discern little of our actual risk. Relative to our outpatient or subspecialty colleagues, the system has saddled us with a distinct data disadvantage. We have no unique identifier or tracking ability, so assessing suitable premiums and sussing out trends within our specialty--and where we fall short (or not), make corrective actions difficult. It would be nice to have a study like this, for example, as the day may come when malpractice carriers disaggregate inpatient from outpatient claims.  Our discipline has weaknesses for sure, like…

Do hospital-based docs get sued more? Part I

  If you want to get the hair on the necks of an audience full of docs to stand on end at a health reform lecture, utter the words salary or malpractice.  Without question, the two most galvanizing issues in our field, they hit hard because we feel their impact both in our professional and personal lives.  In addition, the outsized effects med mal has on our psyche cannot be overstated—especially by those whose shoes have never tread hospital ground.   (more…)

JHM Review: Scope of Practice for NPs/PAs in the Hospitalist Team

In this week’s blog post, I have the pleasure of interviewing Anand Kartha, MD, MS from the Boston VA who is the lead author on a paper that just came out in the Journal of Hospital Medicine this week, “Nurse Practitioner and Physician Assistant Scope of Practice in 118 Acute Care Hospitals.”  Anand and his research team attempted to look at, in this first study, the scope of practice of PAs and NPs in the inpatient setting.  They also explored outcome measures that could be affected by the presence of PAs and NPs.  This is a great first look at how these practitioners work today and has some potential implications for the workforce of the future in hospital medicine. 1.  Why did the research team decide to study APPs who work in hospital medicine and specialty services all in one bucket?  Do you plan to study them separately? The reason we…

Hospitals kowtow to Press Ganey and HCAHPS. Should we?

  We continue to hear about patient satisfaction.  The falsified wait times placing the VA in a state of disrepute serves a good example as any.  Quality measures may be valid under study conditions, but if used improperly or applied in a dysfunctional environment, they help no one. However, we hew to their power, and the data sometimes compel us to work the score, not the patient.  Not news to any of us who feel the impact of quality reporting—through how we receive our compensation or indirectly via the pressure brought to bear by hospital leadership to up the grades. (more…)

Time to Toss Twitter? Not before Trying It out

A recent article in the Atlantic went so far as to eulogize the popular 140-character microblogging service.  This was met with mixed feelings on Twitter, with some agreeing and others lamenting and saying it ain’t so.  Knowing that all technology has a life cycle curve, could it be Twitter would be retired and go the way of MySpace or Friendster?  It seems hard to believe, especially in medicine.  After all, it seems like doctors are just starting to adopt Twitter. This was readily apparent since after attending the typical series of medical conference this Spring, including Hospital Medicine 2014, where the backchannel of Twitter was a flutter with real-time reactions to plenaries and the best places to eat in a particular locale.  Many presenters often had their Twitter handle proudly on display and invited further interaction through Twitter after their presentations.  While it is true that Twitter now is not…